肝纤维化患者肝纤维化程度与血清甲状腺激素水平关系的研究

目的探讨肝纤维化患者肝纤维化程度与血清甲状腺激素水平的关系。方法采用化学发光免疫分析技术检测240例肝纤维化患者（肝纤维化组）及80例体检健康者（对照组）的血清透明质酸（HA）、层黏连蛋白（LN）、Ⅳ型胶原（CIV）、前Ⅲ型胶原（PCⅢ）、促甲状腺激素（TSH）、3,5,3′-三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离甲状腺素3（FT3）、FT4。结果对照组中,≥45岁组的受检者血清HA、LN、CIV、PCⅢ水平明显高于45岁以下组,男性受检者明显高于女性（P〈0.05）;男性受检者血清TSH、T3、T4、FT3、FT4水平明显低于女性（P〈0.05）。随Child-Pugh分级级别的增加,肝纤维化组患者血清肝纤维化指标水平明显升高（P〈0.05）;而其甲状腺激素水平明显降低（P〈0.05）,T3、FT3尤为明显。A、B、C级患者血清HA、LN、CIV、PCⅢ水平明显高于对照组（P〈0.05）;B、C级患者血清T3、T4、FT3、FT4水平明显低于对照组（P〈0.05）。结论肝纤维化程度与血清甲状腺激素水平具有相关性。

A study on the relationship between extent of hepatic fibrosis and serum thyroid hormone levels of patients with liver cirrhosis

Objective To investigate the relationship between extent of hepatic fibrosis and serum thyroid hormone levels in pa-tients with liver cirrhosis .Methods Chemiluminescence immunoassay technology was adopted to detect serum hyaluronic acid （HA）,laminin（LN）,collagen type Ⅳ （CIV）,procollagen type Ⅲ （PC Ⅲ ）,thyroid stimulating hormone（TSH）,triiodothyronine （T3） ,thyroxine（T4） ,free thyroxin 3（FT3） and FT4 of 240 patients with liver fibrosis （liver fibrosis group） and 80 healthy people （control group） .Results In the control group ,serum HA ,LN ,CIV ,PCⅢ levels of healthy people in ≥45-year group were signifi-cantly higher than those in 〈45-year group ,and those in male group were obviously higher than female（P〈0 .05） .Serum TSH , T3 ,T4 ,FT3 ,FT4 levels of healthy people in male group were significantly lower than female （P〈0 .05） .With the increase of grade in Child-Pugh classification ,serum levels of hepatic fibrosis indexes of patients with liver fibrosis increased markedly （P〈0 .05） , while their thyroid hormone levels significantly decreased （P〈0 .05） ,especially in T3 and FT3 .Serum HA ,LN ,CIV ,PCⅢ levels of patients with A ,B or C grade were markedly higher than those in control group（P〈0 .05） ,and serum T3 ,T4 ,FT3 ,FT4 levels of patients with B or C grade were obviously lower than those in control group （P〈0 .05） .Conclusion The extent of liver fibrosis is correlated to serum thyroid hormone levels .